paediatric neurology Flashcards
What are associated presentation with childhood migraine
- abdominal pain
- nausea
- vomiting
- aura such as visual disturbance
- paresthesia
- weakness
- photophobia
- Dark rooms help
- Family history usually
Describe the migraine headache
- Unilateral
- Throbbing or pulsatile
- relieved by rest
- photophobia
- aura
- family history
Describe a tension headache
- Diffuse symetrical headache
- Band constricting like pain
- Present most of the time with a constant ache
What are the red flags for ICP in children with headaches
- Headaches made worse by activities that increase ICP such as coughing, straining and bending
- Waking up from sleep due to the headache, with or without vomiting
Describe analgesic overuse headache
- Patient used too much paracetamol which desensitised the patient to the analgesia
What is the treatment of an acute attack of migraine in children
Triptans
What is the prophylactic management of migraines in children
- Propranolol
- Pizotifen
- Amitryptiline
What is used for treatment of acute pain and then what is used for prophylaxis of Tension type headache
- Simple analgesia for acute attakcs
- Amitryptilline for prevention
What is epilepsy
- A tendency to recurrent, unprovoked epileptic seizures
What is a febrile convulsion
Seizure occuring between 3 months and 5 years - associated with fever but without any
What is the management of Epilepsy in children
- Anti-epeleptics: start with one and then carry out slow upward titration
What is the management for generalised seizures
Sodium valproate but in girls levetiracetam due to sodium valproate affecting pregnancies
What is the first line treatment for focal epilepsies
carbamazepine
What age does the posterior fontanelle close
2-3 months old
What age does the anterior fontanelle close
18 months
What does microcephaly normally indicate
that the brain is small
What is plagiocephaly
Flat head
What is brachycephaly
Short head or flat at the back
What is scaphocephaly
Boat shaped skull
What are the signs of neuromuscular disorder in children
- Floppy baby
- Slips from hands
- small amount of limb movements
- alert but less motor activity
- delayed motor milestones
- frequent falls
What genes are effected in Duchenne muscular dystrophy
Xp21 - dystophin gene
What is the presentation of duchenne muscular dystrophy
- Delayed gross motor skills
- Sympetrical proximal weakness
- waddling gait
- Gowers sign positive
- Calf hypertrophy
- Elevated CK
- Cardiomyopathy
